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Incidence of and Risk Factors for Skin Cancer in Organ Transplant Recipients in the United States.
- Source :
-
JAMA dermatology [JAMA Dermatol] 2017 Mar 01; Vol. 153 (3), pp. 296-303. - Publication Year :
- 2017
-
Abstract
- Importance: Skin cancer is the most common malignancy occurring after organ transplantation. Although previous research has reported an increased risk of skin cancer in solid organ transplant recipients (OTRs), no study has estimated the posttransplant population-based incidence in the United States.<br />Objective: To determine the incidence and evaluate the risk factors for posttransplant skin cancer, including squamous cell carcinoma (SCC), melanoma (MM), and Merkel cell carcinoma (MCC) in a cohort of US OTRs receiving a primary organ transplant in 2003 or 2008.<br />Design, Setting, and Participants: This multicenter retrospective cohort study examined 10 649 adult recipients of a primary transplant performed at 26 centers across the United States in the Transplant Skin Cancer Network during 1 of 2 calendar years (either 2003 or 2008) identified through the Organ Procurement and Transplantation Network (OPTN) database. Recipients of all organs except intestine were included, and the follow-up periods were 5 and 10 years.<br />Main Outcomes and Measures: Incident skin cancer was determined through detailed medical record review. Data on predictors were obtained from the OPTN database. The incidence rates for posttransplant skin cancer overall and for SCC, MM, and MCC were calculated per 100 000 person-years. Potential risk factors for posttransplant skin cancer were tested using multivariate Cox regression analysis to yield adjusted hazard ratios (HR).<br />Results: Overall, 10 649 organ transplant recipients (mean [SD] age, 51 [12] years; 3873 women [36%] and 6776 men [64%]) contributed 59 923 years of follow-up. The incidence rates for posttransplant skin cancer was 1437 per 100 000 person-years. Specific subtype rates for SCC, MM, and MCC were 812, 75, and 2 per 100 000 person-years, respectively. Statistically significant risk factors for posttransplant skin cancer included pretransplant skin cancer (HR, 4.69; 95% CI, 3.26-6.73), male sex (HR, 1.56; 95% CI, 1.34-1.81), white race (HR, 9.04; 95% CI, 6.20-13.18), age at transplant 50 years or older (HR, 2.77; 95% CI, 2.20-3.48), and being transplanted in 2008 vs 2003 (HR, 1.53; 95% CI, 1.22-1.94).<br />Conclusions and Relevance: Posttransplant skin cancer is common, with elevated risk imparted by increased age, white race, male sex, and thoracic organ transplantation. A temporal cohort effect was present. Understanding the risk factors and trends in posttransplant skin cancer is fundamental to targeted screening and prevention in this population.
- Subjects :
- Adolescent
Adult
Age Factors
Aged
Carcinoma, Merkel Cell ethnology
Carcinoma, Squamous Cell ethnology
Female
Follow-Up Studies
Humans
Incidence
Male
Melanoma ethnology
Middle Aged
Retrospective Studies
Risk Factors
Sex Factors
Skin Neoplasms ethnology
United States epidemiology
White People statistics & numerical data
Young Adult
Carcinoma, Merkel Cell epidemiology
Carcinoma, Squamous Cell epidemiology
Melanoma epidemiology
Organ Transplantation statistics & numerical data
Skin Neoplasms epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 2168-6084
- Volume :
- 153
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- JAMA dermatology
- Publication Type :
- Academic Journal
- Accession number :
- 28097368
- Full Text :
- https://doi.org/10.1001/jamadermatol.2016.4920